Improvement is detective work

Among the many traits for which Arthur Conan Doyle’s famous detective, Sherlock Holmes, is known, the most iconic are his deductive reasoning and powers of observation. Sherlock Holmes’ capacity to logically assemble clues and evidence into a cohesive narrative that solved seemingly unsolvable crimes has come to define both his character and the crime fiction genre. His astute observations of otherwise innocuous evidence reliably reveals that, in the words of Sherlock Holmes himself, “The world is full of obvious things which nobody by any chance ever observes.” (The Hound of Baskervilles, Arthur Conan Doyle p. 24).

Of course, we must remember that Sherlock Holmes is a fictional character. He is an amalgamation of ideas, events, interactions, experiences, and people that Arthur Conan Doyle collected over the course of his life. But fiction often reflects reality; thus, it should come as no surprise that the world-renowned detective Sherlock Holmes was largely based on one of Doyle’s medical school teachers, Dr. Joseph Bell.

Fig 2: Sidney Paget’s illustration of Sherlock Holmes for the Strand Magazine story “The Man with the Twisted Lip”

Fig 1: Dr. Joseph Bell, the archetype and inspiration for Sherlock Holmes

A Scottish surgeon and lecturer at the University of Edinburgh Medical School throughout the mid-to-late 1800s, Bell was famous for his powers of observation and deduction. Rather than focus on only the overt and obvious symptoms of disease, Bell urged his students to seize a holistic view. He reminded them that

“Most men have a head, two arms, a mouth, a nose, and a certain number of teeth. But it is the droop of an eyelid or whatnot which differentiates them.”

The whatnot that differentiates one man from another is what the untrained eye overlooks and what Bell espoused that his students look for. Whether it's a patient's gait as they enter a room, the calluses felt while shaking a hand, or subtle differences heard in their dialect, for Bell each interaction with a patient was more than just an expression of good manners and duty. It was an opportunity to collect clues and evidence. It was an opportunity to perform detective work.

In the same way that Bell’s methods provided Doyle with a framework upon which he built the detective Sherlock Holmes, so too do Bell’s methods provide us with a framework for how we investigate the crimes of variation and realize process improvement. Good detective work, whether solving a crime, diagnosing an illness, or improving a process, is a job that requires both specialized knowledge and specialized tools. It requires the synthesis of observation with reasoning. 

In the same way that Bell’s methods provided Doyle with a framework upon which he built the detective Sherlock Holmes, Dr. Walter Shewhart’s methods provide us with a framework for how we investigate the crimes of variation and realize process improvement. Shewhart’s framework for understanding variation, and the subsequent development of the process behavior chart, serve as a venerable combination of specialized knowledge and specialized tool capable of revealing the clues that variation leaves behind. However,

in order to solve the crimes of variation, in order to connect the fingerprints with the perpetrator, it is not enough to simply reveal clues. In order to improve quality and reduce costs we must, as espoused by Dr. Joseph Bell to his students 

“observe everything…use your eyes; use your fingers; use all your faculties before coming to a decision about anything”

Such advice gets to the heart of synthesizing the clues that the virus of variation leaves behind. It gets to the heart of process improvement. While process behavior charts are unrivaled in their capacity to discriminate between the two types of variation, the actions that are required to facilitate improvement are predicated on context. Such context is born from deductive reasoning and observation. It is born from the detective work of spending time with processes and systems. In the absence of observation so too is there an absence of context. In the absence of context, numbers cannot be imbued with meaning and the insights of process behavior charts, as telling as they may be, cannot be turned into actions. In the words of Sherlock Holmes in The Hound of Baskerville, “The world is full of obvious things which nobody by any chance ever observes.” Improvement, at its core, is the practice of learning to observe the obvious things that most others ignore.